Renal/urinary Problems Flashcards by Sarah Heath

What is the approximate volume of urine production every minute by a normal adult

1ml per minute

1-2Liter per day

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Urinalysis of UTI

WBCs
Leukocyte esterase 
May have some proteins 
Might see blood and nitrites 
-certain bacteria will convert nitrates to nitrites

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Is the amount of blood and nitrites in urine an indicator of the severity of the infection of UTI?

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UTI of liver disease

Increased bilirubin

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Urinalysis of low carb diet

Ketones

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Urinalysis of diabetes

Protein, micoralbuminuria

low level of albumin, not small sized albumin
tells if kidney damage is starting to occur

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What is the earliest indicator of kidney damage in diabetes

Microalbuminuria

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Rate at which fluid crossed the glomerular filter

GFR

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What does GFR reflect

Kidney function

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Why is creatinine clearance preferred over inulin

Inulin has to be given IV, and creatinine clearance doesn’t so it’s just easier

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Why is inulin considered the gold standard even though it is not used as commonly as createnine clearance

Freely filtered, neither excreted nor reabsorbed

-required IV infusion of inulin

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How much creatinine is cleared per minute

115-125ml

think of it as a %
if it is above 100, there is probably a 100% kidney function
if only 50, probably only 50% kidney function

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When do you need to calculate creatinine clearance more accurately

When the individual is of an older age and an unhealthy weight

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How do we normally calculate createnine clearance

If you take creatinine clearance and divide by 100%, that gives you kidney function

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When is the creatinine clearance rule of thumb applicable

Only accurate in healthy adults

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How do you get BUN levels from creatinine clearance

Multiple by 10

CC of 2=20BUN

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Most common type of kidney stone

Calcium oxalate

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If you see someone with calcium oxalate in their urine and they suddenly go into renal failure, what is it?

They probably drank antifreeze

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If someone suddenly stops urinating and has pain

Kidney stone

-pain usually only on one side

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Uremia/azoemia

Showing up in the blood, signs and symptoms caused by kidney failing

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Anuria

No urine production

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Amount of plasma filtere/unit time

GFR

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How many nephrons per kidney

1 mill

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How many nephrons can you lose before losing kidney function

75%

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What is the only organ that can get rid of H ions to maintain acid base balance

Kidney

Uremia

Urine in the blood Signs and symptoms of toxins building up Creatinine is good indicator

Casts

Proteins that congeal into tubules in the kidney - normal to see some occasionally - if seeing a lot of them, urine is flowing very slowly through the kidneys

what is the normal protein found in the kidneys responsible for hyaline casts

TAMs-horsfall

Concentration of creatinine clearance is promotional to

Muscle mass

Does creatinine clearance overestimate or underestimate GFR

Overestimate

Does BUN overestimate or underestimate GFR

Underestimate

Between BUN and creatinine, which one is influenced by diet

BUN

Stomach ulcer and BUN

Will increase BUN if there is a bloody stomach ulcer

Kidney stones

Deep, dull pain | Flank pain on one side

Treatment of stones

Manage pain | Get rid of stone

Cysts

Can show up in kidneys and other places - can be simple or many - adult is 40 and older, autosomal dominant - pain or unexplained HTN and blood in urine

Stag horn cysts

Magnesium ammonium phosphate stones

List symptoms of UTI

Burning and pain on urination, lower abdominal comfort

What is the number one cause of UTI

E. coli Staph saprophyticus is common in women too

What’s the difference between and upper and lower UTI

The urinalysis will be pretty much the same Upper UTI will make the person feel very sick and have a fever

Pyelonephritis

Bladder infection that goes up Infectious agents and effects of drugs and toxins Inflammation of the kidneys

Acute pyelonephritis

Caused by UTIs | E. coli

Chronic pyelonephritis

Slowly progressive Responsible for 20% ESRD -polyuria -mild proteinuria

What is associated with WBC cases

Infection caused by polynephrtis

Most common form of acute glomerulonephritis

Post streptococcal glomerulonephritis after URI or pharyngitis that happened about 1-3 weeks ago

What hypersensitivity is acute glomerulonephritis

III (some II)

Acute gomerulonephritis

- Protein, hematuris (cola colored urine) - HTN, RBC casts - ASO - kids recover quick from it - inflammation of nephron - leaking blood and RBC - restrictive so you lose ability of kidneys to filbert blood and lose GFR - azetemia

Nephritis syndrome

Protein levels go up in urine (proteinuria) <3.5g/day RBC and RBC casts Edema around the eyes with increased BP

Signs and symptoms of nephrotic syndrome

- Massive proteinuria - going to lose albumin so edema will follow (pitting) - hypercoagulation due to the loss of ATIII - body compensates for losing protein by increasing lipids, leading to HLD

Differentiate renal insufficiency, renal failure, and ESRD

Renal insufficiency -GFR=20-50% Renal failure - GFR=5-15% - uremia ESRD - GFR<5% - atrophy

Acute renal failure: prerenal

Prevents blood flow to kidney, low BP

Acute renal failure: intrarenal:

Disrupts structures in the kidney

Acute renal failure: postrenal

Interfere with the elimination of urine from the kidney

Uremia

Accumulation of waste products in the blood

Micoralbuminuria in diabetics

Important predictor of future diabetic nephropathies

E. coli

- Gram neg - One of the only lactose fermenting rods - UTI - stains pink

Staph saprophyticus

- gram + - catalase + - coagulate negative - novobiocin resistant - causes UTI in women

Difference in the presence of WBCs in an upper UTI and lower UTI

Lower UTI will have WBCs | Upper UTI will have WBC casts

What are the “opathies” of DM

Neuropathy Retinopathy Nephropathy

What percent of type I DM gets glomerulosclerosis

30%

Most sensitive screening test for diabetics with glomeruclosclerosis

Micoralbuminuria - normal is less than 30mg in 24 hours - 30-300 is a predictor they go into renal failure eventually

When do we see WBC casts

Pyelonephritis

When will we see RBC casts

Glomerulonephritis

Acute tubular necrosis

- destruction of tubular epithelial cells with acute loss or renal failure - reversible usually - aminoglycosides (gentamicin) - low BP and nephrotoxic drugs

Renal/urinary Problems Flashcards

(64 cards)